Method and apparatus for automatically analyzing disorders of the human body



H.- F. GLAssNx-:R ETAL 3,140,710 `METHOD AND APPARATUS FOR AUTOMATICALLYANALYZING DrsoRnERs oF ma HUMAN Booy Filed Feb. 29, 1960 f. 1 4Sheets-Sheet 2 July 1.44. 1964" fran/5X4 July-14. 1964 H. F. GLASSNERHrm. 3,140,710

l METHOD AND APPARATUS FOR AUTOMATICLLY Y y ANALYZING DISORDERS OF THEHUMAN BODY 4 Sheets-Sheet 3 Filed Feb. 2e.' 19Go Q1/O |NoQMAL sommo f. Y:im n J0# if 93 ai C] P 32^O OlAsToLlc MUQMEQ EARLY 9;. LATE l la; l

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sYsToLE l ,July 14 1954 H. F. GLAssNER Erm. 3,140,710 l j v METHOD ANDAPPARATUS FCR UTOMTICALLY 4 l ANALyzING nisoRnERs oF THE-Humm Booy l AFiled Feb. 29. 1960 Y 4 Sheets-Sh'et 4 "V2M/[Ma ,we/yf @Aff/ee JACA H.M750/V t great or too short duration.

United States iiater 3,140,110 METHOD AND APPARATUS FOR CALLY ANALYZINGmsonnuns 0F THE' HUMAN BODY l Harvey F. Gramer, Culver city, Ronald E.smith, T51.

rance, and Jack H. Watson, Los Angeles, Calif., assignors to DouglasAircraft Company, Inc., Santa Monica,

` inea Feb. 29, r1960, ser. No. 11,818

l 16 anims. (ci. 12s-'2.05)

This invention relates to clinical apparatus, andV more particularly' toa unique method and apparatus for analyzing and instantaneouslyclassifying and diagnosing disorders of the body, such as cardiacdisorders and the like.

Various types of techniques and instruments have heretofore beendeveloped to aid the physician in making an analysis of heart disorders.For example, the electrocardiograph provides a continuous recordingl(ile., electro- AUroMA'n j* v asian Patented July 14, l(

rice

throughout this frequency range. On the vother ha| thecharacteristics ofthe human ear aresuch that card sounds below 40 cycles per second cannotbe `detectt `ind since there is so little energy in heat sounds in 1upper frequency range, such soundsabove 750 cycles 1 I*second are belowthethreshold of the human ear. I

`and` his `final insterprtation and an'aylsis ofthe situati I arelargelyaffected by his ability to compute distances l cardiogram) -of thefluctuations of thevelectric potentials gcneratedduring cardiac cycles.The recording is made on a roll of paper that is pre-ruled so as toindicate time intervals, the paper being moved at a constant speedrelative toawritingpen. g

Differentpoxtions of the electrocardiogram are given specicnomenclature, and such portions are determined to be of particularmagnitudes and shapes for a normal heart. .Standards for the range ofnormal values of auricular and ventricula deflections are provided inthe form of tables of measurements made on great numbers of persons indifferent are groups.

The electrocardiograph provides clues'to certain types ofheart'disorders. Such clues` are obtained by inspection of anelectrocardiogram, with reference to the magnitudes of the voltages atdifferent points, the rapidity or frequency of tiuctuations, and theshapes of the different portions of the` voltage wave form, all relativeto the common time base. Consider able diiculty is encountered, however,in determining the nature of a particular disorder because of therequirements of making accurate measurements of the various portions ofthe voltage fluctuations for making the desired comparison. For eachpor# tion, standards have been established for determining whether theVvoltage is high oi'low, or when it is of too very accurate measurementson the electrocardiograrn The physician must make.

erly interpret their meaning. The mechanics of making measurements arequite time-consuming, and it may be said that occasionally' the resultsobtained depend upon how accurate the doctor is in computing distances',ratheri f than upon his medical training.

Other information that forms a complementtor that derived fromelectrocardiograms is in the realm of heart sounds. Heart sounds are, ofcourse, valuable sources of clus for the'detection of heart disorders.Here again,

cycle is important, wheher t'hemurmu'roccurs in the .systolic phase orthe diastolic phase of the cycle. Heart sounds are `known to extend over-a range tif-from 0.5 to

2,000 cycles per secondi-,fObviously fonmany types of heart disorders,valuable information cnkbefobtaine'd tweendilferent portions of graphs,and to relate 1 graphic portrayals ofV wave shapes, frequencies and aplitudes'fto'each other and to an electrocardiogram ti;

Another disadvantage of the prior art techniques a apparatusfor makinganalyses of heart disorders resi: in the inability of diti'erentindividuals to make the sa measurements and interpretations. So Vfar asthe stetl scope is concerned, the significance attached to the ordintensity, pitch, quality, duration and time of occurer of heart soundsmust be based to a considerable'extr upon the ability of the individualphysician to h sounds. `Some physiciansv may be vable to hear sour overa considerably wider range than others, and as result will give anentirely different interpretation of 1 significance of the' sounds heardby them.

Another disadava'ntage of the human ear and the br: is the inability toclearly separate and distinguish betwe closely` spaced sounds. This isencountered, for exam; when tachycardia (excessive rate) is superimposedcardiac disorders or during the stress of concurrent nesses. Thephysician is often unable to provide audio time expansion necessary inthe clear delineati of the closely spad signals,

, Stillanother disadvantage of the prior art techniql and systems foranalyzing electrocardiograms and he sounds is that. despite'the variousapproaches that ha been made,"nrn`e of these Ahas been able to measural)shorten the undesired amountof time required Afor physician to make adiagnosis. After all is said and-do with the electrocardiogram and thevarious graphic p trayals of heart sounds in front 'vof him, the physic.must delve into the Vtime-consuming task of making nu erous measurementsand observations before be can mz a prognosis. 'l'.hismeans that thephysician is resti-ic in the amount of time he can devote to newpatients n are badly in need of his services.

In is an object of this invention to provide a rnetlF and apparatus ofanlyning heart disorders in a man1 that overcomes the above and otherdisadvantages prior art techniques. and apparatus. so:

It fis'j another object of this invention to provide 4 method-and meansfor providing instantaneous anal) of heart soundsend making reliableidentiiicatiomi classification, of heart disorders instantly available.

Itis a further object of this invention to provide sour analyzingapparatus and methods capable of producil Tt 3 on a beat-by-beat,automatic diagnostic'conclusions on the presence and absence of specificheart disorders.

Yet another object of this invention is to provide a.

unique means and method for electrically analyzingv various electricalcharacteristics of a sound within the .human body, and automaticallypresenting 4an observable indication of the presence or absence of aparticular disorder in the body, and the clasification of a disorderthat exists. -t

The above andother objects and advantagesof this invention willbecome'apparent from the following de tive indicators in the presence ofsounds representing pref determined heart disorders, and showing meansfor establishing a time reference for the various channels so as torelate the disorders to predetermined portions of the cardiac cycle; 1

FIGURE-2 is a plot of the signal voltages fromthe filters inthe channelof FIGURE 1 that is adapted to provide indications in the presence ofnormal heart. n

sounds;

FIGURE 3.a is a plot of the signalvoltage from the aorta. As will beapparent, any disease, constriction ot dilation of any of these elementsis a disorder that has ar effect on the heart sound. We `have--discovered that various heart disorders can be identified correctly,from v the characteristics (e.g., amplitude, frequency, wave shapeetc.) ofv heart sounds and their location in the cardiac cycle. For eachof a number of sounds, we establish an energy spectrum', and determinetherefrom wherein the filter in the channel of FIGURE l that is adaptedto provide indications of the existence of a systolic murmur;

FIGURE 3b is a plot of the voltage'obtained from the dfferen'tiator towhich the rectied voltage of FIGURE 3a is applied; t

FIGURE 4a is a plot of the signal voltage from the filter in the channelof FIGURE 1 that provides indications of the'existence of a. diastolicmurmur, indicating the shape of the detected waveform;

FIGURE 4b is aplotof the output of the integrator to which therectifiedvoltage of FIGURE 4a is applied;

FIGURE 5 is a plot ofthe signal voltage from the tilter inthegchannel ofFIGURE l that provides an indication in the presence of the heartcondition known as `a gallop;

FIGURES 6a and 6b are plots of the voltages from the filters in thechannel of FIGURE l that are to provide indications in the presence ofsounds associated with a pericardial rub; and

FIGURE `7 is alfront view of an indicator 'panel for presenting visualindications of various heart disorders during operation of the system ofFIGURE l.

Our invention will be better understood. in the light of the action ofthe heart and our discoveries relative thereto. -As is well known,various factors contribute to heartsounds. Among these is musclemovement, i.e., the physical movements of the heart muscle during contraction and relaxation of the auricles and ventricles. The movement ofblood through the auricles'and ventricles .also contributes to thecharacteristic sounds of Vmajor energyl oi the sound is found. Theamplitudes ol the .various frequency components of the sound `areanalyzed to determine the relative 'magnitudes o f the energy in a givenband that" lpresent in different sounds. The detected wave form, orenvelope, is analyzed in each frequency band to determine wherein thatcom ponent of the sound is distinguishable -over.component. of othersounds in that same band, and how it can be utilized to signify theexistence of the associated sound.

After establishing the energy spectrum for various heart sounds, weadapt electrical circuits for operation in response to themostsignilicant characteristics of certain frequency components. Thedesign and operation of such vcircuits also take into account suchfactors as the duration ofthe particular sound, the number of frequencyportions of the spectrum throughout which the signficant energy isdistributed, the order of appearance of different sound portions, andthe characteristics obtained lby various operations performed onditerent lfrequency portions, e.g., integration differentiation, waveshape detection, frequency relationship. In this manner, each groupingof electronic circuits is arranged to develop signal indications `onlyin the presence of a sound of a predetermined character which visidentifiable with a specific heart disorder. Suitable indicating meanscoupled to each of the groupings ofelectrical circuits provides a visualindication of the existence of a disorder.

stantaneously analyzing a variety of disorders.

Referring to FIGURE l, there is shown microphone pickup dcvie'e 10 to belocated on the chest of a patient The microphone 10 is coupled toanampllier 11 that is provided with a peak automatic control (AGC)network 12 that effectively operates to prevent the amplifie! v outputfrom exceeding a predetermined levell despite tht: magnitudesor'intensities of sounds picked up by the hearts. Another contrioutoristhe laction of the valves'of the heart, as the opening of the mitralandtricuspid valves on opening to admit blood from the left and rightauricles ,r

into the left and right ventricles, and the closing of these valvesduring the .ventricular phase of the cardiac cycle'. Similarly, thephysical 'opening of the aortic and pul'4 monary valves,` to force freshblood from the ventricles in- Mto the lungs and the body, and theclosing of such valves during ow of blood from the auricles into theventricles,

constitutes'a source of noise. v During the cardiac cycl e,the bloodcoming from the extremities enters from`the superior vena cava and from'i f the inferior vena cava into the right auricle, 'thence to the i'microphone f1.0. In this connection, thepeak AGC network 12 may be avolume compressor control means, so that sounds above a predetermineddecibel level result in 'A a gain of the amplitier 11 being reduced,`i,.e., a gain of -the amplifier` l l is reducedto ,agreatr-r extent forvoltages 'Y 'representing ,sounds of greater intensity. Thus, the -sysright ventricle .and to the pulmonary artery. From the Y pulmonaryartery, the blood passes tothe lungs, returntem of our inventionautomatically compensates for wide variations in theintensitiesjoffsounds developed in the heart actions of differentindividuals.` I

Coupled to the amplifier 11 are filter networks 13', 14, 15, 16, 17, I8and 19. Of these, the filters 13 and 14 are utilized in one channel inconjunction with an amplitier 20. To this end, a detector 21 is coupledbetween the filter 14 and the amplifier 20. The gain of the amplifier 20is controlled by the output of the detector so that in the presence of aSignal from the filter, the gain of the amplifier 2t) is reduced.-A y Yv i An indicator 22 is coupled tothe amplifier 20.*throu'gh a triggercircuit 23,. and is arranged to provide an observable indicaton, cg.,illumination of a lamp, inra" situation wherein a signal is present inthe output of the filter 13, and wherein there is no signal in theoutput of the filter v 14. l In'this situation, the gain ofthe amplifieris high, and v the signal from the filter 13 is amplified to operate theindicator means 25.' For this purpose, a ditterentator network .26 isconnected tothe filter 15, and aV suitable trigger 27 is connectedbetween the diffe'rentiator 26 and the indicator 25.

liet-eas the channel that includes theflter '15 isadapted todifferentiate certain frequency components, the channel that includesthe filter 16 is adapted, through an integrator 30, to integrate certainfrequency components. A trigger network 31 is coupled between the inte-ggrator -and an indicator 32.

Other frequency components of the input signalare passed through thefilter 17 to be processed on the basis of its trave shape. Such waveshape detection is effected by a detector network 35 and a tuned filter36. When a portion of the envelope of the detected signal uctuates atthe frequency to which the filter 36 is tuned, a signal appears in the-output of the filter 36 sufficient to establish operation of a triggercircuit 37 and an indicator 38.

The filters 18 and 19 are located in a channel in which an indicator 40is to be operated in the event that certain frequeu` components of theinput signal occur in a predetermined sequence. The earlier frequencycomponent is passed by the filter 18, and is delayed by -a delay nct.

work 41 until the subsequently arriving different frequency component ispassed through the filter 19.

W'nen signals appear -simultaneously in the outputs of the filter 19 andthe delay network 41, they are summed,

as indicated at 42, to obtain a voltage for operating a trigger 43 thatcontrols the indicator 40.

The envelope 54 will-be seen to be double humped, and to be symmetricalrelative` to the low point 55 between the vhumps. In the system' ofFiGUR 1, the detector'35 is biased so that. only the portions of thevoltage 54 above the point 55 appear in its output, indicated at a level56.

In this manner, an4 essentially sinusoidal voltage is developed, landthe tuned filter 36 is turned t5 the frequency of such sinusoidalvoltage. Accordingly, only a signal of predetermined. wave shapelpandfrequency, peculiarlyA identifiable with the presystolicngallop, resultsin a voltage being applied to the trigger 3 7; Therefore, the indicator38 operates only in the presence of this particular disorder.

FIGURE 3a illustrates the voltage 58 of a sound frequency in the rangeof 20-30c.p.s. The envelope 59 of Athc lvoltage 53 will be seen to risesharply and then fall.

gradually. `Differentiation of the detected Waveform 59 results in4a'sharp pulse 60 (see FIGURE 3b) that is For analyzing the cardiacdisorders previously menl tioned with the above-described syste-rn,variouscharacteristics ofthe sounds associated -with such disorders wereanalyzed, and we found that one or more of the charactcn'stirs offrequency, amplitude, wave shape, and timing were identifiable with aspecific sound, and hence with the associated' disorder. Also, one ormore of these characteristics are capable of being processed in a mannerto vavoid any possibility of confusion over the disorder identificationrepresented thereby.

Considering thc five sounds associated with the normal heart sound. thesystolic and diastolic` murmurs, the gallop and the pericardial rub, wediscovered the following characteristics peculiar to them:

A significantly large part of the energy of the normal sound occurs at75 vc.p.s. (cycles per second);

The presystolic gallop has the major portion of its energyin thev658()c.p.s. band. Yet the gallop sound has a' `wave shape distinctlydifferent from the normal sound; Also, there is a strong 150-c.p.s.component inl the gallop sound, and there is no such componentin the,normaal sound. Furthermore,` none of the other sounds have anyrelatively significant energy at.` these different frequencies. Y I

FiGURE 2 illustrates voltage waveforms 50, 5.1 correspending to the75c.p.s. and l50c.p.s. components mentioned. As seen in FIGURE 1, thelter 13 is designed, to pass the 75-c.p.s. voltage 50, and the filter 14is' adapted -to pass the 15G-cps. voltage 51. Since the voltage 51 isassociate-d with a cardiac disorder, its utilization to reduce the gainof theamplifier 20 prevents an indication for.

identifp'ng a normal sound from being erroneously created in the4presence of a sound associated with a systolic gallop.

Regarding-the systolic gallop, FIGURE 5 illustrates ment.

used to operate the trigger 27. This variation in the 20-30c.p.s.waveform ispeculiar to the systolic mur-v mur, and the maior portion ofthe energy of the associated sound is in this frequency range.

The maior energy of the sound of a diastolic murmur was found to be inthe 300-400-c.p.s. range. FIGURE 4a illustrates the voltage 51 of asignal in this range.- -As seen by its envelope 62, this voltage slowlyuctuates in a decreasing manner. 'We utlizethis characteristic to obtainan integrated voltage 64 (see FIGURE 4b) with which to operate thetrigger 31 and the indicator 32.

In the comparison of the five sounds as mentioned,v

we found that only the pericardial rub produced a sound having a strongl75-c.p.sl component. Additionally, the pericardial rub is characterizedas a sound having different frequency components occurring insuccession, and in which a strong 70c.p.s. component follows the 175-c.p.s. component. FIGURES 6a and 6b illustrate the high frequencyvoltage 65 and the low frequency voltage 66 'occurring iny sequence. Asillustrated, we prepare for addition by delaying the voltage 65 (by thedelay network 41) until the 'peaks of theirenvclopcs 652,66' are inaligntrigger 43. t

In order to properly analyze a sound and identify a e cardiac disordertherefrom, the sound must be properly placed in the cardiac cycle. Inthe foregoing description,

it was assumed, for purposes of explanation, that the which utilizesthis information to provide the identifying electrode pickup means 70provides electrical signalsthat follow the bodys electricalv signalvariations created during the cardiac cycle. T he' pickup 70 is coupledthrough i an amplifier 71 and a filter 72 to a graph recorder' 73 forproviding the conventional electrocardiogram.

, The output of the filter 72 is also fed to a trigger 74 for operatinga timer 75. The timer 75 is one that de.- t .velops voltages atdifferent intervals, the occurrence'of such voltages depending upon thecharacteristics of the signal 'from the trigger, and hence theparticular' elec-` In one example, 'the timer"4 ldevelops voltagesduring the early, middle and late systolic, and the early, middle, andlate diastolic portions of I the cycle, as at respective output leads81, 82, 83, S4,

trocardiographic voltage.

as, s6.

f The leads-81436 are connected to respective indicators 91-96, such aslamps, to become illuminated .during the various portionsof the heartcycle.

Also, these leads 81-36 are coupled to respective systole bias anddiastole bias networks 97, 98.-` The vias networks 97, 9 8 may Thesubsequentadd-itionof these voltages providcs-v a much higher voltagey67A forl applicatiodto'the comprise a pair of amplifiers to developsignals in respective output connections 99, 100 in response to signalsin any of the leads 81-83 and 84-36. For example, the

groups of leads 81.-83 and 84-85 may be connected to the grids ofrespective vacuum-tube amplifiers, the output connections-99, 100 beingin the plate circuits. The

systole bias output connection 99 is coupled-to those a normal soundneed not depend upon the existence of a systole or diastole marker forits operation. Such indicator 22 is of the type that operates inresponse to one 4input signal (from the trigger 23).

FIGURE 7. shows one example of a visual display to identify the aboveheart disorder to the observer. A

panel 102 contains labels 163, 104, 105,106, 101 showing the names ofthe disorders, andthe indicators 22, 25, 32, 38 and 40 are locatedadjacent the proper labels. These indicators. operate in conjunctionwith the systole indicators 91, 92, 93 and the dastole indicators topositively identify the disorder analyzed by the electrical apparatus.`For example, the systolic murmur indicator 25, and the diastole lateindicator are illuminated in the presence of a sound associated with apresystoiic murmur. To aid the physician, an amplifier 110 andloudspeaker 111 combination (see FIGURE l) may be cpupled to theamplifier 11 for providing audible reproduction of heart sounds.

As will be apparent from the foregoing, our invention embraces a varietyof means for processing sound signals from experimentally determineddata, and for automatically analyzing different sounds and identifyingbody channels aredescribedfor use in determining fiv'e heart disorders,it is apparent that our invention is not limited to any particularnumber of channels.

Nor is our invention limited to the particular arrangements forprocessing signals. As will be apparent, any desired processing meansmay be employed, so long as it effects the necessary indication in thepresence of `a sound associated with a disorder that such means is toidentify. l

It should be noted that our unique method and apparatus are adapted toanalyze a single heart beat and provide an indication of the disorder.This result permits vthe physician to closely follow any pattern ordisorder as the heart rate var cs over a wide range, an impossibleachievement for prior art methods and apparatus.

Iitview of the foregoing, it will be apparent that various modificationscan be made in the apparatus shown and describedjwithout departing fromthe spirit and scope of our invention. For example, if heat sounds areexplored "at different areas, the microphone is located at differentpositions. From such different points, heart sounds me made up ofdifferent frequency components. In such case,y a microphone positionvfeedback may be employed, where- Vin all of the filters are adjustedsimultaneously as neces'- sary upon-changing the position of themicrophone.

Other time bases may be employed instead of the electrocardiograph type,e.g., pressure waves. Graph recording of heart disorders may beemployed, as by utilizing the operation of an indicator to .operate awriting unit in conjunction 'with that of the electrocardtogram. Also,

l 97, 98. As will be apparent, an indicatorassociated with disorderstherefrom.- For example, although five signal v output.

We claim:

1. The method of analyzing and classifying body sound to' automaticaliydiagnose a cardiac condition which comprises: applying a transducer to apatients body to develop an electrical signal corresponding to the bodysound; filtering said signal to pass a modified signal ofa'predetermined frequency determined by the value of said filter,`

which modified signal and frequency are characteristic but notconclusive of the existence of a certain cardiac condition; operating onsaid modified signal to produce a' resultant signal which uniquelyrepresents said certain oody condition; applying said resultant signalto means indicating by the presence of said resultant signal thediagnostc presence of said certain cardiac condition; applyingelectrical pickup means to the body and developing therefrom voltagesindicative of the separate portions of the` ventricular phase of theheart cycle; and applying a signal to said indicating means of adeveloped voltage indicative of a particular portion of the heart cycleso that the iri4 tiicating means will give a diagnostic indication only'signal occurs in the proper portion ofvand a lyina the combined out utsto means indicatin PP P.

a diagnosis ci normal body condition u here there is a substantialoutput from the first filter and no substantial output through thesecond filter, anda diagnosis of an abnormal body condition where thesecond filter has a sul. stantial output.

3. The method o automatically sampling a heart sound to determine thepresence or absence of a systolic murmur which comprises: applyingl atransducer to afpatients body to develop an electrical signalcorresponding to the heart sound; passing said electricalA signalthrougha filter passing electrical frequencies inthe rangeof20-3,0'.p.s.; differentiating the output, if any, of said filter;and'applying thedifierentiatcd output to means indicating an automaticdiagnostic conclusion of the presence of a systolic murmur by the natureof said differentiated output.

' 4'. The method of automatically sampling 'a heart sound to determinethe presence or absence of a diastolic murmur which comprises: applyingatransducer to a patients body to develop an electricalsignalcorresponding to the heart sound; passing said electrical signal througha filter passing electrical frequencies in the range of 30G-400 c.p.s.;integrating the output, if any, of said filter; and applying saidintegrated outputto means indicating an automatic diagnostic conclusionof the presence of a diastolic murmur by the nature of said integrated5. The method of automatically diagncsin g the presence of a systolicgallop from 'heart sound which comprises: applying a transducer to apatients body to develop an electrical signal corresponding'to the heartsound; passing said electrical signal through a filter designed to passa band of frequencies of from' 65 to 80 cps.; passing said filter outputthrough a detector to determine the frequency of the envelope of theelectrical signal; passing said envelope signal through a tuned filter;and applying the outl put of the tuned filter to means` automaticallyindicating severity cf heart disorders may be indicated,- Vas by circuitmeans operating severe and mild indcators.- Accordingly; we do notintend that our invention shall be limited e .cept as defined Vby theappended clazms.

a diagnostic conclusion of the presence of systolic'gallop from saidtuned filter voutput.

A 6. The method of automaticallydiagnosing the presence' o a pericardialrub from heat sound which comprises: applying a transducer to apatient's body to develop an electrical signal corresponding to heartsound;

,',passing lsaid electrical signal through rst `and second )waaraan .uw

'icc-.scies of substantially' 70 cps.; delaying the output dt' said rstfiller in time until it is in phase with the output et" siiidsecondlter; adding said delayed first and second outputs; and applying theresult of .the addition to means automatically indicatinga diagnosticconclusion of the presence of a percardial rubby the magnitude oi' saidresult. i

7. The method of automatic diagnosis defined in elm 3, including thesteps of applying electrical pickup means to the body and developingtherefrom electrical voltages indicative respectivelyof the systole anddiastole portions of the heart cycle; and applying the voltageindicative of the systole portion to said indicating means to give anautomatic diagnosis of systolic murmur o nly when the differe-ri'tiatedoutput occurs in proper time phase with the voltage indicative ofthesystolic portion of the heartcycje.

8. The method of automatic diagnosis defined in claim 4, including thesteps of applying electrical pickup means to the body and developingtherefrom electrical voltages indicative respectively of the systole anddiastole portions of the heart cycle; and applying the voltageindicative of v the diastole portion to said indicating means to give`anautomatic diagnosis of diastolic murmur only when the integratedoutput occurs in properV time phase with the .voitage indicative of thediastole portion f the heart cvclc. j 9. The methodof automaticdiagnosis defined in Vclaim 5, including the steps of applyingelectrical pickup means to the body and dev'eoping therefrom electricalvoltages indicative respectively of thesystole and diastole portions ofthe heart cycle; and applying the voltage indicative o the systoleportion to said indicating means to gt3-'e an automatic diagnosis ofsystolic gallop only when .the tuned filter output occurs in proper timephase ,withthe voltage indicatiye of the systolic portion of iheheartcycle.

l0. Apparatus for automatically diagnosing the condition of the humanheart from body sound which comprises: transducer means for picking upbody sound and i) existence ot' a conditionV is based also upon 'thepro; 'elation of the resultant'signal to the portion of the he: cycle.

l2. Apparatus for 'effecting automatic diagnosis body conditioncomprising: means for developing an elt trical signal in response tobody sound; means for filtt ing said signal to pass a modified signal ofa predetermin frequency characteristic but not conclusive of the presenof a certain body condition; means for operating on sa modified signalto produce aresultant signal which uniqt ly represents said certain bodycondition;and means f automatically giving a diagnostic conclusion of t'presence of said certain body condition fromv the presen developing anelectrical signal4 corresponding theieto; a

filter circuit through which said'signal is passed to produce a lfilteroutput signal of predetermined frequency '.z'hicli is characteristic butnot conclusive of the existence of a certain heart condition; means forelectrically operat`v y ing on said filter output signal to produce aresultant signal which uniquely represents said certain heart condition;

means lfor,developirigwoltages indicative of the separate portions ofthe ventricular phase of the heart cycle; means for automatically givinga diagnostic indication o the existence of said certain hcart condition;and means feeding both said resulmnt signal and a selected voltage tosaid indication means to give a diagnostic indication when a resultantsignal occurs in the proper portion of the heart cycle as determined bysaid selected voltage. 1

.11. Apparatus for analyzing and-classifying heart sc und toautomatically diagnose a heart condtion comprising: transducer means forpicking up heart sound and developing anelectrical signal conformingthereto; a plurality of parallel filter circuits passing frequencies ofvarious values, which frequencies are characteristic but not con elusiveofthe existence of certain heart conditions; means for feeding saidelectrical signal through said filter circuits; means for-operating onthe outputs, if any, of said ter circuits to produce resultant signalswhich lare. uniquely'idicat'ive of the existence of said certain heartconditions;`=iii dicating lmeans for 'cach resultant signal for v givinga diagnostic conclusioin of the existence of the certain heartcondition'of which it is indicative; means for generating voltagescorresponding to the systole and dia stoleA portions of 'the heart'cycle :ind to the time parts of said portions in which heart soundsoccur; means for diagnostically indicating said time parts of saidportions; f and means for combining said voltages with the resultantsignals for systolic and diastolic heart conditions in said indicatingmeans so that the 'diagnostic conclusion of the of said resultantsignal, said filtering means including substantially c. .s. filtercircuit and said operatii means including a substantially c.p.s. filtercrci whose output modifies the output of the 75 c.p.s. fill circuit togive an automatic diagnostic conclusion of nc mal or abnormal heartcondition. y

13. Apparatus for effecting automatic diagnosis I body conditioncomprising: means for developing an ele trical signal in response tobody sound; means for filt'e ing said signal to pass a modified signalof a predete mined frequency characteristic but not conclusive of tlpresence of certain body condition; means for operatii on said modifiedsignal to produce a resultant signal whit uniquely represents saidcertain body condition; ar cans for automatically giving a diagnosticconclusie of the presence of said certain body condition from tlpresence of said resultant signal, said tiltering'means pas ingfrequencies between 20 c.p.s. and 30 cps., said opera ing meansincluding a differentiator for the output of tl filtering means to givean automatic diagnostic conch sion of the' presence of a systolic heartmurmur.

14. Apparatus for effecting automatic diagnosis t body conditioncomprising: means for developing a electrical signal in response to bodysound; means ft .'ltering said signal to pass a modified lsignal of apredete mined frequency characteristic but not conclusive of tl.presence of a certain body condition; means for operatir on saidmodified signal to produce a resultant signal whic uniquely represents:said certain lbody condition; an means for automatically giving adiagnostic conclusie ofthe presence of said certain bodyv condition fromtt presence of said resultant signal, said ltering'means pas ingfrequencies-in the band'betwcen 300"c.p.s. and 4C c.p.s., saidAoperating means .including airintegrator ft integrating the output ofthe: ltering'rneans to. give a automatic diagnostic conclusion of thepresence of a di: stolic heart murmur.

l5. Apparatus for effecting automatic diagnosis of bod conditioncomprising: means 'for developing an electric: signal in response tobody sound; means for filtering sai signal to pass a modified signal ofa predetermined fri 'quency characteristic but not conclusive of thepresenc of a certain body condition; means for operating on sai modifiedsignal tol produce a resultant signal which unique ly represents saidcertain body condition; and means fc automatically giving a diagnosticconclusion of -tli presence of said certainA body condition from thepresen: of said resultant signal, said filtering -mea'ns passing fr:quencies between 65 c.p.s. and 8O c.p.s .vfsaid o peratin meanscomprising a detector for the envelope. of the oui put of the filtering-mcans anda tunedtilterI throughfwhic the envelope signal is passed tcprovide a resultant'signz providing for an automaticdiagnosticconclusion of sy: tolic gallop of the heart f 16. Apparatus foreliecting automatic diagnosis o body condition comprising: means fordeveloping a eletrical signal in response to body sound; means foltering said signal to pass a modified signal of apre operating on saidmodified signal to produce a resultan

11. APPARATUS FOR ANALYZING AND CLASSIFYING HEART SOUND TO AUTOMATICALLYDIAGNOSE A HEART CONDITION COMPRISING: TRANSDUCER MEANS FOR PICKING UPHEART SOUND AND DEVELOPING AN ELECTRICAL SIGNAL CONFORMING THERETO; APLURALITY OF PARALLEL FILTER CIRCUITS PASSING FREQUENCIES OF VARIOUSVALUES, WHICH FREQUENCIES ARE CHARACTERISTIC BUT NOT CONCLUSIVE OF THEEXISTENCE OF CERTAIN HEART CONDITIONS; MEANS FOR FEEDING SAID ELECTRICALSIGNAL THROUGH SAID FILTER CIRCUITS; MEANS FOR OPERATING ON THE OUTPUTS,IF ANY, OF SAID FILTER CIRCUITS TO PRODUCE RESULTANT SIGNALS WHICH AREUNIQUELY INDICATIVE OF THE EXISTENCE OF SAID CERTAIN HEART CONDITIONS;INDICATING MEANS FOR EACH RESULTANT SIGNAL FOR GIVING A DIAGNOSTICCONCLUSION OF THE EXISTENCE OF THE CERTAIN HEART CONDITION OF WHICH ITIS INDICATIVE; MEANS FOR GENERATING VOLTAGES CORRESPONDING TO THESYSTOLE AND DIASTOLE PORTIONS OF THE HEART CYCLE AND TO THE TIME PARTSOF SAID PORTIONS IN WHICH HEART SOUNDS OCCUR; MEANS FOR DIAGNOSTICALLYINDICATING SAID TIME PARTS OF SAID PORTIONS; AND MEANS FOR COMBININGSAID VOLTAGES WITH THE RESULTANT SIGNALS FOR SYSTOLIC AND DIASTOLICHEART CONDITIONS IN SAID INDICATING MEANS SO THAT THE DIAGNOSTICCONCLUSION OF THE EXISTENCE OF A CONDITION IS BASED ALSO UPON THE PROPERRELATION OF THE RESULTANT SIGNAL TO THE PORTION OF THE HEART CYCLE.